Why the study?
Childhood cancer survivors face increased cardiovascular morbidity and mortality, but modifiable lifestyle factors such as physical activity, nutrition, and body weight have not received enough attention for cardiovascular risk reduction.
These practical recommendations emphasize the integration of modifiable lifestyle factors, such as physical activity, alongside standard primary and secondary prevention and screening for cardiovascular disease in childhood cancer survivors.
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Lifestyle recommendations may warrant consideration in childhood cancer survivor follow-up; leaves open confirmation of cardiovascular benefit in prospective trials.
BACKGROUND: Childhood cancer survivors are at increased risk of developing cardiovascular diseases, presenting as the main causes of morbidity and mortality within this group. Besides the usual primary and secondary prevention in combination with screening during follow-up, the modifiable lifestyle factors of physical activity, nutrition, and body weight have not yet gained enough attention regarding potential cardiovascular risk reduction. OBJECTIVE: These practical recommendations aim to provide summarised information and practical implications to paediatricians and health professionals treating childhood cancer survivors to reduce the risk of cardiovascular late effects. METHODS: The content derives from either published guidelines or expert opinions from Association of European Paediatric and Congenital Cardiology working groups and is in accordance with current state-of-the-art. RESULTS: All usual methods of prevention and screening regarding the risk, monitoring, and treatment of occurring cardiovascular diseases are summarised. Additionally, modifiable lifestyle factors are explained, and clear practical implications are named. CONCLUSION: Modifiable lifestyle factors should definitely be considered as a cost-effective and complementary approach to already implemented follow-up care programs in cardio-oncology, which can be actively addressed by the survivors themselves. However, treating physicians are strongly encouraged to support survivors to develop and maintain a healthy lifestyle, including physical activity as one of the major influencing factors. This article summarises relevant background information and provides specific practical recommendations on how to advise survivors to increase their level of physical activity.
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Kesting et al. (2024) conducted a review in Cardiovascular disease in childhood cancer survivors. Physical activity and lifestyle changes was evaluated. Modifiable lifestyle factors, including physical activity and nutrition, should be integrated into follow-up care to reduce the risk of cardiovascular late effects in childhood cancer survivors.
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